Local DSA Chapter Sign-up

This form is for DSA chapter leaders to tell us about your ongoing or
incipient Medicare for All or related healthcare activism. If you are a
chapter or OC leader, or lead activist in your chapter's Medicare for
All/healthcare committee or working group, please let us know what you
are up to and what you need!

Name*

Email*

ZIP Code*

State*

What chapter/organizing committee are you in?*

What are your roles in the chapter, elected and otherwise?*

Does your chapter have a Medicare for All or healthcare activism committee/working group?

Has your chapter adopted a resolution endorsing the National Medicare for All Campaign?You can find and adapt a draft of such a resolution here.

If yes, who are the leaders of that committee/working group?

What is your chapter doing as part of its healthcare activism?Check all that apply.

Canvassing

Direct action

Lobbying

Medicaid signups

Educational events

Workplace organizing

Tell us more about that! What exactly have you done and since when? If your work doesn't fit in the descriptions above, please describe it below.

Would you be willing to help train other chapters on how to do these actions?

What kind of support for this campaign do you think would be most helpful from National DSA?